Visualization of the critical isthmus by tracking delayed potential in edited windows for scar-related ventricular tachycardia

Ju Youn Kim, Woo Seung Shin, Tae Seok Kim, Sung Hwan Kim, Ji Hoon Kim, Sung Won Jang, Hui Nam Pak, Gi Byoung Nam, Man Young Lee, Tai Ho Rho, Yong Seog Oh

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Abstract

Background and Objectives: Identifying the critical isthmus of slow conduction is crucial for successful treatment of scar-related ventricular tachycardia. Current 3D mapping is not designed for tracking the critical isthmus and may lead to a risk of extensive ablation. We edited the algorithm to track the delayed potential in order to visualize the isthmus and compared the edited map with a conventional map. Subjects and Methods: We marked every point that showed delayed potential with blue color. After substrate mapping, we edited to reset the annotation from true ventricular potential to delayed potential and then changed the window of interest from the conventional zone (early, 50-60%; late, 40-50% from peak of QRS) to the edited zone (early, 80-90%; late, 10-20%) for every blue point. Finally, we compared the propagation maps before and after editing. Results: We analyzed five scar-related ventricular tachycardia cases. In the propagation maps, the resetting map showed the critical isthmus and entrance and exit sites of tachycardia that showed figure 8 reentry. However, conventional maps only showed the earliest ventricular activation sites and searched for focal tachycardia. All of the tachycardia cases were terminated by ablating the area around the isthmus. Conclusion: Identifying the channel and direction of the critical isthmus by a new editing method to track delayed potential is essential in scar-related tachycardia.

Original languageEnglish
Pages (from-to)56-62
Number of pages7
JournalKorean Circulation Journal
Volume46
Issue number1
DOIs
Publication statusPublished - 2016 Jan

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All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Kim, J. Y., Shin, W. S., Kim, T. S., Kim, S. H., Kim, J. H., Jang, S. W., Pak, H. N., Nam, G. B., Lee, M. Y., Rho, T. H., & Oh, Y. S. (2016). Visualization of the critical isthmus by tracking delayed potential in edited windows for scar-related ventricular tachycardia. Korean Circulation Journal, 46(1), 56-62. https://doi.org/10.4070/kcj.2016.46.1.56